Antibiotic-resistant E.coli in supermarket meat “worse than expected”

A new study has shown extremely high levels of E.coli resistant to essential antibiotics - used to treat human E.coli infections – present in British supermarket chicken and pork.

The research, carried out by scientists at Cambridge University and commissioned by the Alliance to Save our Antibiotics, is the first to examine UK-origin retail meat for resistance to a variety of antibiotics for treating E.coli infections.

There was a concerning level of resistant E.coli in chicken meat, with 24% of samples testing positive for ESBL E.coli – a strain of the infection resistant to ‘critically important’ modern cephalosporin antibiotics. A similar study from last year showed that only 6% of chicken tested positive for ESBL E.coli, four times fewer than this year. Modern cephalosporins are largely used to treat life-threatening E.coli blood poisoning in humans.

In addition, it uncovered high levels of resistance to two more important antibiotics.

Over half (51%) of E.coli from pork and poultry samples were resistant to the antibiotic trimethoprim, which is used to treat over half of the lower urinary-tract infections.

189 UK-origin pig and poultry meat samples were tested from the seven largest supermarkets in the UK – Aldi, Asda, Morrisons, Sainsbury’s, Tesco and Waitrose - as part of the study. The presence of E.coli resistant to important antibiotics for treating E.coli urinary-tract and blood-poisoning infections in people were examined during the research. The resistant ESBL E.coli was found on meat from all of the supermarkets.

The research supports evidence that the overuse of antibiotics used to treat mass livestock is likely to undermine the treatment of E.coli urinary-tract and blood-poisoning infections in humans.

Supermarkets called to take immediate steps

“These findings show the level of antibiotic resistance on retail meat to be worse than expected,” explained Emma Rose from the Alliance to Save our Antibiotics. “Supermarkets must now publicly commit to policies which prohibit the routine mass-medication of groups of healthy animals, and take immediate steps to reduce farm us of ‘Critically Important’ drugs.”

Data from the Alliance to Save our Antibiotics show that the number of E.coli blood poisoning infections has been increasing over the last 25 years and reached a record of 45,666 in 2015. It is believed that this rise is partly being driven by increasing resistance to key antibiotics in urinary-tract infections, which is resulting in more treatment failures and in some incidents the development of serious blood-poisoning infections.

“I’m concerned that insufficient resources are being put into the surveillance of antibiotic resistance in farm animals and retail meat,” commented Dr Mark Holmes from Cambridge University, who led the study. “We don’t know if these levels are rising or falling in the absence of an effective monitoring system. These results highlight the need for improvements in antibiotic stewardship in veterinary medicine. While some progress has been made we must not be complacent as it may take many years before we see significant reductions in the numbers of antibiotic-resistant bacteria found in farms.”

The overuse of antibiotics in human medicine is also believed to be part of the issue whilst the routine dosing of animals on intensive farms raised in disease-inducing conditions is also a contributing factor.

Dr Ron Daniels BEM, chief executive of the UK Sepsis Trust highlighted that the study shows a worrying trend towards rising resistance to the infection. “E.coli in people is the greatest cause of deaths from sepsis, and poor antimicrobial stewardship in intensive farming is undoubtedly contributing to this trend,” he said. “It’s of paramount importance that we act decisively to reduce this immediate threat to human life.”

Over the last few years, the Alliance has raised the concern with all major retailers and claims to have seen good progress from Waitrose. In 2015, the supermarket stated that antibiotics would not be used for routine prophylaxis in its supply chains. It also recently updated its policy to state that it will be working towards significant year-on-year reductions in usage of all antibiotics. The Alliance is now calling on other major supermarkets to follow suit and reduce its use of antibiotics and to ban the routine preventative mass-medication of groups of animals.

"Worst fears" confirmed

“These results show how vital it is to encourage farming systems that keep animals healthy without abusing medicines that are crucial to human health. Organic farmers have been doing this successfully for years,” said Peter Melchett, policy director for the Soil Association. “Supermarkets must act to protect public health and support farmers to change their farming systems.”

Philip Lymbery, chief executive for Compassion in World Farming added: “This new study reveals our worst fears: without a drastic change in the over-use of antibiotics on factory farms, we could be facing a post-antibiotic era. We must no longer sacrifice animal welfare for the sake of producing cheap meat.”

Contradictory evidence

Whilst the National Pig Assocation (NPA) said that it is unsurprising that the E.Coli was found on pork considering its nature, the association also pointed out that "the evidence of the presence of ESBL E.coli in pork is contradictory; the report intitally states that one pork sample tested positive, wheares the annexe states no pork samples tested positive".

It was also pointed out by the NPA that no resistance to fluoroquinolones or colistin, which are critically important to human medicine, in the porcine E.coli were found. "This demontrates just how safe pork is and reinforces all the hard work and progress currently driving the pig industry."

The NPA said that the sample size was limited, which could subsequently impact the accuracy and significance of teh results, whilst the provenance of the tested pigmeat was not revealed, meaning that it could not be British.

"Bacterial infections such as E.coli may cause pain and discomfort to animals," said the NPA. "The treatment of such infections is a requirement of both national and EU animal welfare legislation and all veterinarians are under oath to protect the welfare of the animals in their care. The agricultural and veterinary industries are acutely aware that responsible use of antiobiotics is vital to ensure AMR in animal pathogens doesn't become more of a problem in the future for human health and animal health and welfare."

A statement from the British Poultry Council said that the poultry sector has reduced its use of antibiotics by 44% since 2012. "The industry has recognised a problem, taken action, and made its commitment clear in our report: ‘Leading the Way in the Responsible Use of Antibiotics’," said the council.

"We've never claimed to have all the answers, and the impacts of our precautionary approach are in the process of being fully realised and analysed. Our priority remains the health of our birds and the responsible therapeutic use of antibiotics, but we also need to explore further into the science of the issue.

"Resistance is complex and we have seen evidence of it persisting even after stopping the use of antibiotics. Like any life, bacteria are subject to natural selection so we need to continue challenging the resistant bacteria in an environment hostile to its continuation. How best to do this is just one of the incredibly difficult questions we and the scientific community are trying to answer.

"E.Coli, the bacteria currently under focus, is common in both livestock and humans. Good kitchen hygiene practices - in handling and cooking of meat - will kill the bacteria.

"There is no sound-bite answer when it comes to antibiotics. Antibiotic resistance is an incredibly important subject for both animal and human health. The British poultry sector is determined to proceed along the route of responsible and reducing use. Using fewer antibiotics will put less pressure on bacteria in the poultry production chain to select for resistance, and we will see that resistance drop.

"Under the auspices of the BPC Antibiotic Stewardship Scheme the sector is committed to driving best practice across the industry. A 44% reduction in use of antibiotics is amazing during a period when UK production of poultry meat rose by 5%, and is due in large part to our highly skilled practitioners playing their part in a global issue."

Chairman of t he Responsible Use of Medicines in Agriculture (RUMA) Alliance, Gwyn Jones, said that the farming industry recognises concerns about growing resistance to antibiotics, but resistance in humans remains largely attributed to human medical use. He said that good hygiene practice in the kitchem will almost completely prevent the transmission of antimicrobial resistance from meat to humans.

“Despite this, the farming industry must also play its part to control spread of resistance," he admitted. "This is why RUMA announced in May it is setting up an industry task force to look at how meaningful targets can be developed to replace, reduce and refine antibiotic use in UK agriculture. That group is now being formed and a first meeting will be held shortly.”

“Sales into farming of fluoroquinolones and 3rd and 4th generation cephalosporins, which are CIAs, are already very low in the UK, representing just 0.9% of the total,” he explained.

“In 2012 the poultry meat industry introduced a voluntary ban on the use of 3rd and 4th generation cephalosporins, and a commitment to reduce the use of fluoroquinolones which has since led to an overall reduction. The 3rd and 4th generation cephalosporins authorised for use in pigs cannot be given in-feed or in-water and are only ever administered to individual animals.

“Furthermore, despite colistin making up less than 0.2% of UK antibiotic use in UK livestock, RUMA announced a voluntary restriction in December 2015 that it should only be used as the last effective antibiotic available for treating the sick animal.

“So while it’s very positive that no colistin and fluoroquinolone resistance was found in these samples, the discovery of bacteria resistant to modern cephalosporins when so few are being used only serves to underline the complexity of this issue, and the need to tread carefully – as interventions are not without consequence.”